Late Treatment of Displaced Intra-Articular Calcaneus Fractures: Successful Management With Anatomic Reduction
| Autor: | John R. Shank, Stephen K. Benirschke, Michael P. Swords, Nicole Fraticelli |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Intra-Articular Fractures medicine.medical_treatment Radiography 03 medical and health sciences Fixation (surgical) Fracture Fixation Internal Fractures Bone 0302 clinical medicine Fracture fixation medicine Internal fixation Humans Orthopedics and Sports Medicine Foot Injuries Retrospective Studies 030222 orthopedics business.industry 030208 emergency & critical care medicine General Medicine medicine.disease Polytrauma Surgery Calcaneus Treatment Outcome Foot Injury Complication business |
| Zdroj: | Journal of orthopaedic trauma. 34 |
| ISSN: | 1531-2291 |
| Popis: | Introduction The aim of this study was to evaluate the results of displaced intra-articular calcaneus fractures treated more than 25 days after injury by open reduction and internal fixation (ORIF) using a lateral extensile surgical approach. Methods Twenty patients identified by retrospective review of our trauma database were treated with ORIF for a displaced intra-articular calcaneus fracture more than 25 days after injury. OTA/AO 82-B and 82-C fracture patterns were included. All had ORIF by a lateral extensile approach. Bohler's angle was measured on injury radiographs, after operative fixation and the final follow-up and compared with the Bohler's angle of the contralateral uninjured extremity. Patients completed a Musculoskeletal Function Assessment (MFA) to evaluate the functional outcome. Results The mean number of days from injury to fixation was 33.4 days (range, 26-58 days). A total of 18/20 patients were available for follow-up (mean 26.1 months; range 12.5-100 months). Eleven injuries were joint depression (82-C), and 7 injuries were tongue type (82-B) fracture patterns. The reason for delayed presentation was delayed transfer to our institution (11 patients), hemodynamic instability from polytrauma (2 patients), excessive fracture blisters (2 patients), and sepsis (1 patient). Bohler's angle at the time of injury was a mean of 10.9 degrees, which corrected to a mean of 33.3 after operative fixation but decreased to a mean of 28.1 at the time of the final follow-up. The mean Bohler angle was 32.3 on the contralateral uninjured side. The mean MFA score was 16.5 (range, 1-34). There were no wound infections or subtalar arthrodesis procedures performed. Conclusions ORIF by a lateral extensile approach is a safe and viable option for patients presenting in a delayed fashion with a displaced intraarticular calcaneus fracture. Marked improvement in the Bohler angle, acceptable functional outcome, and low complication rates can be expected when surgery is performed by an experienced surgeon. Level of evidence Level IV. See Instructions for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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